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Fibromyalgia is a neurological condition and associated with somatic and psychological disorders that can cause extreme pain throughout the body. This issue affects roughly 4 million US adults, and cannot be cured, only managed with treatment. Fibromyalgia primarily causes problems of pain and stiffness, fatigue, depression, anxiety, sleep problems, including producing headaches and migraines.

Recent research regarding CBD shows its wide-ranging therapeutic potential, which has piqued interest for its potential healing properties in other fields of treatment, including fibromyalgia.Cannabis comes in numerous forms and can provide relief from symptoms of fibromyalgia due to its extensive therapeutic index. Apart from cannabis’s general complexities, productively utilizing cannabis products will undoubtedly allow holistic attributes to promote wellness best. CBD has proved to be an effective form of therapy for assisting in symptom management for fibromyalgia, including pain attenuation when used to modulate the body’s endocannabinoid system.

The Endocannabinoid System

Endocannabinoid receptors exist in our body, with higher concentrations mainly at the cortex, cerebellum, basal ganglia, hippocampus, spinal cord, and peripheral nerves. It’s a complex system that helps regulate many physiological processes.

Without having ever tried cannabis, our bodies naturally produce endogenous cannabinoids. The ECS brings itself to a state of homeostasis by releasing these endogenous cannabinoids to bring balance to our ECS’s.

Cannabinoids

Cannabinoids are a broad term that describes any chemical compound that binds to our cannabinoid receptors. There are two main cannabinoids:

• Phytocannabinoids - derived from nature, found in cannabis
• Endocannabinoids - naturally occurring in our bodies

Both interact with our endocannabinoid system and helps promote wellness when our body needs to bring modulation

Endocannabinoids

Endocannabinoids will release when the body’s ECS is unbalanced to bring our body back to a homeostasis state. The CB1 and CB2 receptors exist in our brain, organs, immune system, and glands. It monitors your mood, movement, sleep, metabolism, and other vital functions of our body.

Phytocannabinoids

Phytocannabinoids are molecules that modulate the ECS, such as tetrahydrocannabinol (THC) or cannabidiol (CBD). These cannabinoids are in plants, which include cannabigerol (CBG), cannabinol (CBN), tetrahydrocannabivarin (THCV), and many more. All with unique roles in the endocannabinoid system. The endogenous cannabinoids our body produces are anandamide (referred to as the bliss molecule) and 2-arachidonoylglycerol (2-AG).

What is CBD?

Cannabidiol communicates naturally with our endocannabinoid system as a partial agonist to CB1 and CB2 receptors by stimulating serotonergic receptors. Hemp, or cannabis sativa, is seen with higher CBD numbers and has copious additional medicinal benefits, including neurological pain, by providing balance to our endocannabinoid system.

Cannabidiol or CBD is a non-intoxicating phytocannabinoid found in cannabis and is now legal in the United States under the Farm Bill, which went into law on December 20, 2018. The Farm Bill allows hemp to be grown for industrial and medicinal uses, as long as it’s less than .03% tetrahydrocannabinol (THC).

Interacting Within our ECS

Both phytocannabinoids and endocannabinoids stimulate 5-HT1A, along with the TRP-V receptors known for their serotonin release when taking cannabidiol. CBD interacts within our endocannabinoid system in different ways.

CBD activates the 5-HT1A serotonin receptor. This receptor assists in a myriad of neurological processes, including how pain is perceived and regulating nausea and anxiety. CBD also binds to the TRPV1 receptors (along with anandamide). TRPV1 is also referred to as the “vanilloid receptor,” and are ion channels that also participate in pain reduction.

Clinical Endocannabinoid Deficiency

Dr.Ethan B Russo explores the purpose of cannabis in the theory of CED. Clinical endocannabinoid deficiency is a theory that certain brain disorders are an issue with deficiencies within our neurotransmitters, affecting acetylcholine, dopamine, serotonin, and norepinephrine. These chemicals play roles in Alzheimer’s, depression, parkinsonian syndromes, and anxiety.

According to the theory, all humans have concealed cannabinoid deficiencies, and CED states that when our ECS is unbalanced, issues occur due to genetic and congenital reasons. These can escalate to pathophysiological syndromes, including migraines, irritable bowels syndromes, and fibromyalgia.

CBD and Fibromyalgia

In 2019, Milan, Italy, researchers obtained hundreds of patients for a study specifically on cannabis and fibromyalgia. The participants ranged in age, averaging 52 years of age, with the majority being women. The patents were taking other drugs at the time of the study and weren’t happy with the results. The patients found that the pharmaceuticals used for treatment weren't working for their symptoms.

Pharmaceuticals for Fibromyalgia

Much of what is currently available for fibromyalgia treatment is a multidisciplinary method that can include traditional pharmacological treatment, therapy, and physical therapy. Also, some employ meditative movement therapies, as well.

Pharmaceuticals used for the treatment of fibromyalgia are opioids, anticonvulsants, antidepressants, anti-anxiety, and sedatives. These prescriptions often bring substantial side effects, making people want to lean into holistic remedies such as cannabis. During a 2019 study titled Safety and Efficacy of Medical Cannabis in Fibromyalgia, nearly half of the individuals noted that cannabis could reduce painkillers.

CBD Study

The 2019 research paper was able to identify individuals who used cannabis as a treatment for fibromyalgia found great relief from symptoms. The people who stayed throughout the study found some encouraging outcomes, showing:

• Roughly 81% of patients were able to receive some form of relief from using cannabis
• 92% of patients were able to find success with sleep-related problem
• Nearly 60% percent of patients found cannabis treated depression-related symptoms

The study went on to say that subjects experienced benefits in relation to insomnia, anxiety, depression, and general comfort level. This isn’t surprising as CBD has proven therapeutic properties that can reduce symptoms associated with fibromyalgia.

Additional Fibromyalgia Research

Researchers examined the possibilities of cannabis being utilized as an efficient approach for fibromyalgia by performing a double-blind, placebo-controlled, 4 way crossover study using female participants. On five different occasions, the patients were seen and received their cannabis treatment with two weeks between each visit. The study was able to find that despite not fully interacting with the CB1 receptor, there were still extensive bonuses to using CBD as an analgesic due to its ability to modulate the serotonergic receptors and TRPV1.

Methods of Usages

Researchers used cannabis vapor during the study, as when cannabis is decarboxylated, the effects are felt immediately instead of some other methods. This isn’t to say those other ways of consuming CBD wouldn’t be effective. Consuming CBD tincture is a popular option with most patients that aren’t interested in inhaling cannabis that can similarly modulate your endocannabinoid system and promote similar results.

Tinctures absorb sublingually which allows for faster absorption results than with other edible products. Tinctures provide a convenient way to take CBD orally, removing the need for decarboxylation. A tincture begins to absorb sublingually when placed underneath the tongue, and this can provide faster onset effects sooner than with some edibles. Furthermore, tinctures can also be applied topically, continuing to note the versatility of phytocannabinoids.

Not everyone is interested in consuming cannabis for psychoactive effects. Studies show that CBD has been shown to help with inflammation and pain when taken orally. However, it’s also proven useful in assisting with pain relief when applied topically.

Topicals

When cannabis is applied as an ointment, oil, or another form on the skin, there are no associated psychoactive effects. Unless otherwise stated, most products will not be able to penetrate the epidermis to enter the bloodstream. This method can be a favorable method for individuals that aren’t interested in intoxicating effects but are looking for localized pain relief.

Edibles

Edibles are another popular choice with individuals looking for a smokeless way to consume. Edibles typically contain cannabis-infused butter or cannabis concentrate, making for a potent product that most often allows for body-focused and euphoric effects. Most edibles will take time to digest, so it’s cautioned to start with a small amount of THC and slowly work up over some time to have the best experience. Edibles can come in different ratios of THC and CBD, including hemp-based CBD edibles that allow this for convenience and the ability to find a consistent, tolerable dose.

Conclusion

The endocannabinoid system is a complex system that exists to bring homeostasis to our bodies when one of the numerous physiological processes it regulates needs it. Current research about CBD is showing to provide immense benefits with symptom relief to fibromyalgia. Although clinical studies are limited, the current research about CBD and its effects on anxiety, depression, sleep, and other symptoms, including pain management, are showing to be hopeful.

The more research that is focused on regarding CBD as an effective treatment for fibromyalgia, the more patients can benefit from the overall use across the different portions of life. Whether inhaled, used topically, or otherwise, CBD proves to once again be a holistic power house for lessening symptoms.